Effectiveness of live health professional-led group eHealth interventions for adult mental health: systematic review of randomized controlled trials
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Date
2022
Authors
Currie, Cheryl L.
Larouche, Richard
Voss, Lauren
Trottier, Maegan
Spiwak, Rae
Higa, Erin
Scott, David R.
Tallow, Treena
Journal Title
Journal ISSN
Volume Title
Publisher
JMIR Publications
Abstract
Background: The COVID-19 pandemic has had adverse impacts on mental health and substance use worldwide. Systematic
reviews suggest eHealth interventions can be effective at addressing these problems. However, strong positive eHealth outcomes
are often tied to the intensity of web-based therapist guidance, which has time and cost implications that can make the population
scale-up of more effective interventions difficult. A way to offset cost while maintaining the intensity of therapist guidance is to
offer eHealth programs to groups rather than more standard one-on-one formats.
Objective: This systematic review aims to assess experimental evidence for the effectiveness of live health professional–led
group eHealth interventions on mental health, substance use, or bereavement among community-dwelling adults. Within the
articles selected for our primary aim, we also seek to examine the impact of interventions that encourage physical activity compared
with those that do not.
Methods: Overall, 4 databases (MEDLINE, CINAHL, PsycINFO, and the Cochrane Library) were searched in July 2020.
Eligible studies were randomized controlled trials (RCTs) of eHealth interventions led by health professionals and delivered
entirely to adult groups by videoconference, teleconference, or webchat. Eligible studies reported mental health, substance use,
or bereavement as primary outcomes. The results were examined by outcome, eHealth platform, and intervention length.
Postintervention data were used to calculate effect size by study. The findings were summarized using the Synthesis Without
Meta-Analysis guidelines. Risk of bias was assessed using the Cochrane Collaboration Tool.
Results: Of the 4099 identified studies, 21 (0.51%) RCTs representing 20 interventions met the inclusion criteria. These studies
examined mental health outcomes among 2438 participants (sample size range: 47-361 participants per study) across 7 countries.
When effect sizes were pooled, live health professional–led group eHealth interventions had a medium effect on reducing anxiety
compared with inactive (Cohen d=0.57) or active control (Cohen d=0.48), a medium to small effect on reducing depression
compared with inactive (Cohen d=0.61) or active control (Cohen d=0.21), and mixed effects on mental distress and coping.
Interventions led by videoconference, and those that provided 8-12 hours of live health professional–led group contact had more
robust effects on adult mental health. Risk of bias was high in 91% (19/21) of the studies. Heterogeneity across interventions was significant, resulting in low to very low quality of evidence. No eligible RCT was found that examined substance use, bereavement, or physical activity.
Conclusions: Live eHealth group interventions led by health professionals can foster moderate improvements in anxiety and
moderate to small improvements in depression among community-based adults, particularly those delivered by videoconference
and those providing 8-12 hours of synchronous engagement.
Description
Open access article. Creative Commons Attribution 4.0 License (CC BY 4.0) applies
Keywords
Systematic review , Telemedicine , eHealth , mHealth , e-therapy , Mobile interventions , Adult , Depression , Substance use , Physical activity , CBT , Group , Synchronous , Videoconference , Teleconference
Citation
Currie, C. L., Larouche, R., Voss, L., Trottier, M., Spiwak, R., Higa, E., Scott, D. R., & Tallow, T. (2022). Effectiveness of live health professional-led group eHealth interventions for adult mental health: Systematic review of randomized controlled trials. Journal of Medical Internet Research, 24(1), E27939. https://www.jmir.org/2022/1/e27939/